As an applicant, you must prepare and submit supporting documentation relating to your agency's operating policies and procedures.

This is a critical component of the application process and if not prepared thoroughly will delay or result in denial of your application.

READ CAREFULLY: Once you are familiar with all of the Wisconsin Administrative Rule requirements within DHS 131, you must develop policies related to each of the following. Each policy must clearly be outlined and labeled with it's corresponding rule requirement:

A. Policies/Procedures and materials related to:

Patient Rights - DHS 131.19

Service Agreement - DHS 131.17(4)(b)

Governing Body - DHS 131.28

Administrator - DHS 131.29

Orientation Program - DHS 131.31(3)

Continuous Training - DHS 131.31(5)

Infection Control - DHS 131.23

Evaluation - DHS 131.31(6)

Personnel Practices - DHS 131.31(7)

Volunteers - DHS 131.27

Health Care Records - DHS 131.33

Content

Protection of Records

Entries

Medical Symbols and Abbreviations

Quality Assessment and Performance Improvement - DHS 131.22

Admission - DHS 131.17

Plan of Care - DHS 131.21

Bereavement Program - DHS 131.25(6)(a)

Discharge - DHS 131.18

Reporting & Investigation of Caregiver Misconduct - DHS 13

B. Job Descriptions

Administrator - DHS 131.29

Volunteer - DHS 131.27

Medical Director - DHS 131.32

Nurses - DHS 131.25(4)

Social Services - DHS 131.25(5)

Bereavement - DHS 131.25(6)(a)

Non-core Services - DHS 131.26

If these services will be provided, include documentation to support their credentials: